Apocrine carcinoma of the skin. A clinicopathologic, Immunocytochemical, and ultrastructural study

Abstract

Background. Apocrine carcinomas of the skin are rare and incompletely studied neoplasms. Methods. An immunohistochemical and ultrastructural study is reported of specimens from six patients with apocrine skin carcinoma in various body sites. Three tumors were in the axilla; one, the eyelid; one, the ear; and one, the scalp. There were three local recurrences and three regional lymph node metastases, but no patient died of cancer (follow‐up, 2–10 years). Results. The most reliable histopathologic criteria for identifying apocrine skin carcinoma appear to be decapitation secretion, periodic acid‐Schiff‐positive diastase‐resistant material in the cells or lumen, and immuno‐reactivity with gross cystic disease fluid protein 15. All specimens expressed common epithelial antigens (cytokeratins, carcinoembryonic antigen, and epithelial membrane antigen) and histiocytic‐secretive antigens (Leu‐M1, lysozyme, LN5, alpha‐1‐antitrypsin, and alpha‐1‐antichymotrypsin). S‐100 protein was found in the three nonaxillary tumors. Ultrastructurally, the primary tumors, and especially the secondary lesions, were dedifferentiated compared with normal apocrine glands. Conclusions. Apocrine differentiation in skin tumors does not indicate an exclusive origin from the apocrine sweat glands; these neoplasms usually have an indolent clinical course.

Adnexal skin tumors in Zaria, Nigeria

“…One report noted the axilla as the preferred site. 6 They represented 11.5% of the 52 tumors reviewed, further emphasizing their rarity. Malignant appendage tumors were the least common in one report, 7 with four cases confined to the scalp and trunk and accounting for 3.3% of total tumors analyzed, and 2.3% in another report.…”

Carcinoma apócrino na glândula parótida e na região submandibular

“…To complement the information on morphological findings, we can also detect other aspects for the diagnosis of apocrine origin of tumor: presence of iron-positive granules in neoplastic cells 3 , presence of positive PAS material resistant to diastase in tumor cells and lumen, and positive immunelabeling in neoplastic cells 3 ; presence of positive PAS material resistant to diastase in tumor cells and in lumen 5 , and positive immunereaction to two or three antigens comprising GCDFP-15 (gross cystic disease fluid protein-15), lisozime and CD-15 4 .…”

“…Considering the prognosis, skin apocrine carcinoma is normally associated with a non-fatal evolution of the disease, but local recurrences and metastases to regional lymph nodes may occur years after the first excision 3 . Moreover, only moderately or little differentiated lesions produce metastases or lead the patient to death 7 .…”

“…The onset of apocrine carcinomas outside these conditions is also uncommon, and there are only 32 cases reported in the literature review conducted by Katagiri and Ansai 4 , whose epidemiological aspects are the following: preferential age range over 40 years, absence of gender or race preference, more frequent location in the armpits, but there are reports also on the scalp, chest, frontal region, spleen, hand, finger and lip. This type of tumor has been reported as apocrine carcinoma, apocrine gland carcinoma, duct-papillary apocrine carcinoma, cutaneous apocrine carcinoma or cutaneous ductal apocrine carcinoma 1,3,[5][6][7] .…”

“…According to Hayes et al 2 and Paties et al 3 , forms of carcinoma with apocrine differentiation are normally related with extramammary Paget disease, breast ductal carcinoma, adenocarcinoma of Moll's glands, and ceruminal carcinoma. The onset of apocrine carcinomas outside these conditions is also uncommon, and there are only 32 cases reported in the literature review conducted by Katagiri and Ansai 4 , whose epidemiological aspects are the following: preferential age range over 40 years, absence of gender or race preference, more frequent location in the armpits, but there are reports also on the scalp, chest, frontal region, spleen, hand, finger and lip.…”